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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series B, Convertible Preferred Stock, $0.01 par per share | $ 15 (2) | 05/24/2005 | P | 976,660 | 05/24/2005 | 05/24/2015 | Common Stock, $0.01 par value | 976,660 | $ 15 (2) | 976,660 | D | ||||
Warrant to purchase Common Stock | $ 0.5 | 05/24/2005 | X | 1,000,000 | 08/04/2004 | 01/31/2007 | Common Stock, $0.01 par value per share | 1,000,000 | $ 15 (2) | 0 | D | ||||
Warrant to purchase Common Stock | $ 1.3 | 05/24/2005 | P | 488,330 | 05/24/2005 | 05/24/2010 | Common Stock, $0.01 par value | 488,330 (2) | $ 15 (2) | 488,330 (2) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
ADLER FREDERICK R 1520 SOUTH OCEAN BLVD PALM BEACH, FL 33480 |
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Frederick R. Adler | 06/23/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Consists of 10,100 shares of Common Stock held by 1520 Partners, LP, a limited partnership of which the Reporting Person is the general partner. The Reporting Person disclaims beneficial ownership of the shares held by 1520 Partners, LP. |
(2) | The reported securities are included within 48,833 units purchased by the Reporting Person for $15.00 per unit. Each unit consists of one share of Series B Convertible Preferred Stock of the Issuer and a warrant to purchase 10 shares of common stock of the Issuer. Each share of Series B Convertible Preferred Stock is convertible into 20 shares of common stock. |
Remarks: This form amends and restates in its entirety the Form 4 filed by the Reporting Person on 5/26/2005. |